Points requiring attention in primary-care settings in the treatment of patients with acute drug intoxication / 日本プライマリ・ケア連合学会誌

Objective: To develop an effective and safe therapeutic strategy, we studied the effect of the clinical characteristics of patients with acute drug intoxication on the duration of hospitalization. <br>Subjects and Methods: The subjects were 89 patients hospitalized for acute drug intoxication. They were divided into two subgroups; the short hospitalization group (duration of hospitalization < 7 days) and the long hospitalization group (duration of hospitalization ≥ 7 days). We compared age, sex, vital signs, drugs, and therapy between the two groups. <br>Results: There were no significant differences in sex or severity of consciousness disturbance between the short- and long-hospitalization groups. Age in the latter group was higher than that in the former, and age was significantly and positively correlated with the duration of hospitalization. Prolongation of hospitalization in patients with Japan Coma Scale (JCS) I or II is associated with psychiatric disease, and in patients with JCSIII, with physical disease. We used direct hemoperfusion (DHP) to treat patients with severe acute drug intoxication. The duration of hospitalization in patients treated by DHP tended to be shorter than those not so treated. <br>Conclusions: The present results suggest that aging is associated with prolongation of hospitalization and the onset of physical disease among patients with acute drug intoxication. When elderly patients with acute drug intoxication are treated in a primary-care setting, the question of whether or not physical diseases are present as complications should be considered. The appropriate use of DHP for the treatment of patients with severe acute drug intoxication requires further study.

Behavior of Adult Influenza Patients during the 2009 Pandemic after Outpatient Clinic Presentations at a Hospital in Tokyo, Japan

The 2009 pandemic of novel swine-origin influenza A (H1N1) highlighted the importance of community mitigation measures such as voluntary isolation. During the pandemic, we investigated the voluntary isolation behavior of patients with influenza during the 7-day period after they visited an outpatient clinic at a hospital in Tokyo, Japan. A questionnaire-based survey was conducted on patients diagnosed with influenza. Of a total of 14 patients, 13 (93%) visited a workplace, school or other potentially crowded setting at least once in the 7-day period after presentation. Five patients (36%) visited a potentially crowded setting either with a fever or on the day after having a fever. The voluntary isolation behavior of Japanese people with influenza did not necessarily adhere to the Japanese government recommendation that people with influenza-like illness stay home for 7 days following the onset of symptoms.